<div class="modal fade" id="dialog-contact" tabindex="-1" role="dialog">
    <div class="modal-dialog" style="padding-top: 50px;">
        <div class="modal-content">
            <div class="modal-header">
                <button type="button" class="close" data-dismiss="modal"
                        aria-hidden="true">&times;</button>
                <h4 class="modal-title">Gửi email</h4>
            </div>
            <div class="modal-body">
                <form class="form-horizontal" role="form">
                    <div class="form-group">
                        <label class="col-sm-3 control-label">Họ tên*</label>
                        <div class="col-sm-9">
                            <input type="text" class="form-control" placeholder="Nguyễn Văn A">
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-sm-3 control-label">Email*</label>
                        <div class="col-sm-9">
                            <input type="email" class="form-control" placeholder="bcb@gmail.com">
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-sm-3 control-label">Điện thoại</label>
                        <div class="col-sm-9">
                            <input type="text" class="form-control" placeholder="(08) 38 212 121">
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-sm-3 control-label">Địa chỉ</label>
                        <div class="col-sm-9">
                            <input type="text" class="form-control" placeholder="Số 10 Nguyễn Thị Minh Khai P1, Q1, Tp.HCM">
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-sm-3 control-label">Nội dung</label>
                        <div class="col-sm-9">
                            <textarea style="resize:none" class="form-control" placeholder="..."></textarea>
                        </div>
                    </div>
                    <div class="form-group" style="margin-bottom: 0;">
                        <div class="col-sm-12 text-right">
                            <button type="button" class="btn btn-lestyle-1" tabindex="4">
                                GỬI
                            </button>
                        </div>
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>